Family History and the Risk for Breast or Ovarian Cancer

Topic Overview

But if someone in your family has had breast or ovarian cancer, your
chances of getting those cancers may be higher. And if you have 2 or 3 relatives who have had these cancers, your chances may be even higher.

If you have a
family history of breast or ovarian cancer, it may be important to you to find
out how high your risk is so that you can decide whether to do something to
lower that risk, like take medicine or have surgery.

The best way
to find out about your risk is to talk to your doctor. But you can get some
idea of how high your risk is by knowing your family history and understanding
how it relates to breast and ovarian cancers.

What is a family history?

Having a family history means that you
have one or more blood relatives with breast or ovarian cancer.

They may be relatives who have died or relatives
who are still alive.

They may be first-degree relatives (parents,
sisters, brothers, and children).

Or they may be second-degree
relatives (aunts, uncles, nieces, nephews, and grandparents), or third-degree
relatives, which includes first cousins.

Some family histories are stronger than others. Here's what
determines whether your family history is strong:

How closely related you are to relatives with
breast or ovarian cancer. Cancer in first-degree relatives increases your risk
the most.

How young these relatives were when they were diagnosed. Having
any relatives who were diagnosed before age 50 adds to your
risk.

Whether you have both breast and ovarian cancer in your
family. Having both adds to your risk.

Whether you have a father or brother who had breast cancer.
Breast cancer in men is rare, but when it happens in your family, it adds to
your risk.

Whether you have an Ashkenazi Jewish heritage. Breast
and ovarian cancer rates are much higher among Ashkenazi Jews (Jews whose
ancestors came from Eastern Europe).

In the tables below, the figures are only rough estimates
from research studies. Lifetime risk means the chance that you will get these
cancers sometime during your life. These numbers may not apply to you, but they
can give you an idea of how high your risk may be.

See a picture that may help you understand how much
having a family history can increase your risk for ovarian cancer.

Your doctor
will ask about at least three generations of your family history and tell you
how much it affects your risk. Your doctor may also send you to a
genetic counselor, someone who is trained to help
people understand their risks for certain diseases.

What is a BRCA gene change?

Sometimes a very
strong family history is caused by a mutated
gene that runs in the family.

BRCA1 and
BRCA2 are genes that normally help control cell growth. But an inherited
change, called a mutation, in one of these genes makes you much more likely to
get breast and ovarian cancers. BRCA (say "BRAH-kuh") stands for BReast CAncer.
A BRCA gene test is a blood test that can tell you and your doctor whether you
have one of these changed genes.

Having a BRCA gene change is
rare. Most women with a strong family history of breast or ovarian
cancer don't have a BRCA gene change.

Before you have a gene
test, you will need to see a genetic counselor. Counseling will help you make
an informed decision about whether to have a BRCA gene test. It is often
covered by insurance, but check with your insurance company to find out for
sure.

Are an Ashkenazi Jew (a Jewish person whose ancestors came from Eastern Europe).

In the table below, the figures are only rough estimates from
research studies. Lifetime risk means the chance that you will get this cancer
sometime during your life. These numbers may not apply to you, but they can
give you an idea of how high your risk may be.

In the table above, the range for BRCA gene carriers is very
broad. That's because different studies have had different results. More study
is needed to get a clearer idea of what the risk is for women who have a BRCA gene change.

Pictures may help you understand these numbers better. See
the following pictures to get a better idea of how much a BRCA gene change
increases your risk for:

How can you find out what effect your family history has on your risk?

The best way to find out is to
see your doctor. Your doctor will ask you for as much information about your
relatives as you can give (for example, what kind of cancer they had, if any;
how old they were when they were diagnosed; and, if they have died, how old
they were when they died).

People often don't have a lot of
information about all of their relatives. The more you can find out, the better
your doctor can help you figure out how strong your family history is.

Your doctor may send you to a genetic counselor, who can help you learn
how high your cancer risk is. After counseling, you may decide to have a BRCA
gene test.

The discovery of a genetic disease that isn't causing symptoms now (such as breast cancer or Huntington's disease) should not affect your ability to gain employment or health insurance coverage. A law in the United States, called the Genetic Information Nondiscrimination Act of 2008 (GINA), protects people who have DNA differences that may affect their health. This law does not cover life insurance, disability insurance, or long-term care insurance.

Finding out how high your risk is can help you make
important decisions about your health. Some women decide to take extra steps to
prevent breast and ovarian cancer, such as having checkups more often, taking
anti-cancer medicine, or having surgery to remove the breasts, the ovaries, or
both.

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